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Jan. 25, 2010 -- Injuries in youth soccer are common, and rates are higher among players younger than age 15, a new analysis shows.

Reporting in the February issue of Pediatrics, researchers say that soccer -- one of the most popular team sports in the world -- is almost synonymous with injuries. Young female players tend to suffer more knee-related injuries, while male soccer players are more likely to report more ankle injuries, the researchers write.

The researchers say that prevention programs could reduce the number of knee injuries through specialized exercise programs and should be promoted by coaches and officials of soccer leagues.

Female players, the researchers report, have a slightly higher risk of concussion than male players. The risk of head injury is about the same in soccer as it is in other contact-collision sports, but the researchers say the evidence doesn't support "heading" -- using the head to propel or stop the ball -- as a risk for short- or long-term cognitive problems.

The researchers say enforcing the rules of the game and discouraging overtly aggressive or dangerous play could help, because many soccer players get hurt when either the play becomes unsafe or because of conditions that go with the sport.

It's estimated that 15.5 million people in the U.S. participate in soccer. Two national youth organizations have registered 650,000 and 3.2 million participants under the age of 19. The number of female adolescent players increased 7% between 2001 and 2007.

The researchers say more than 700,000 girls and boys played soccer in high schools in the U.S. in 2008-2009, placing soccer among the top sports for increased participation.

With increased participation comes an increasing prevalence of youths injured while playing soccer showing up in pediatric offices, the study says.

According to the researchers, the Consumer Product Safety Commission (CPSC) estimated there were 186,544 soccer-related injuries in 2006, about 80% affecting young people under 24. Forty-four percent of the injuries, the researchers write, occurred in players younger than 15.

Types of Soccer Injuries

The researchers say they studied records from the CPSC's National Electronic Injury Surveillance System.

They report that:

Girls' and boys' teams may expect four and 3.5 injuries per season, respectively.

Boys have a higher risk of suffering injuries during games.

Knee injuries are more common in soccer played outdoors than inside.

Uneven playing surfaces can cause excessive "loading" of ligaments and muscles and may contribute to improper landing after jumping.

A common injury in young players is Sever disease, or technically, calcaneal apophysitis, which is attributable, at least in part, to playing on hard fields with cleats that don't have enough heel and arch support.

Most injuries result either from player-to-player contact or player contact with the ground, the ball, or goalposts.

Contact injuries occur mostly when players are tackling the ball, being tackled, or hitting the ball with their heads.

Ankle injuries account for 16% to 29% of injuries to the lower extremities -- the most common problem. Knee injuries are the problem in 7% to 36% of injured players.

Upper extremity injuries represent 3% to 12% of total injuries, with the shoulder and the wrist, hand, or elbow being affected most.

The researchers say a common serious injury that doctors see is a rupture of the anterior cruciate ligament (ACL) -- a tear in one of the knee ligaments that joins the upper and lower leg bones.

Previous research has indicated that female collegiate soccer players have a 2.8 times greater risk of ACL rupture than male players do, the researchers write, but some evidence suggests the increased risk is closer to four to six times for females.

Soccer can be good for health, the researchers say, but children, adolescents, and young adults should be encouraged to participate often in other forms of physical activity in addition to soccer.